Ex-post-facto analysis of competitive employment outcomes for individuals with mental retardation: National perspective
Employment outcomes have often been used as a benchmark of vocational rehabilitation success. Not until the Rehabilitation Act of 1973, were states required to target individuals with significant disabilities for services using an order of selection process. Because of the functional differences that exist between individuals with mild, moderate and significant cognitive disabilities, rehabilitation counselors must be aware of the types of services most needed and those services that more often result in high quality employment outcomes for each target group.
The purpose of this study was to provide a snapshot to generate new knowledge that rehabilitation counselors can apply to enhance competitive employment outcome placements for individuals of varying abilities. In addition, the purpose of the study was to identify disparities in the proportions of competitive job placements between individuals with mild, moderate, and significant cognitive disabilities.
This study included individuals with disabilities served by multiple vocational rehabilitation agencies in various settings.
The study sample included all consumers with cognitive disabilities closed into Status 26 during fiscal year 1998 in the RSA-911 national database maintained by the Rehabilitation Services Administration. This included a total of 28,565 consumers: mild (n = 17,033, 60%), moderate (n = 9,784, 34%), severe/profound (n = 1,748, 6.1%).
The data was obtained from the individual client closure reports and RSA-911 national data tape, provided by the Rehabilitation Services Administration (RSA). The authors used two tests of statistical significance: chi-square and logistic regression analysis. Chi-square analysis was conducted for type of mental retardation and work status at closure. In addition the authors conducted a post hoc pairwise comparisons (2 x 2 chi-square) for mild by moderate, mild by severe/profound and moderate by severe/profound. To guard against Type I errors, the authors used the Bonferroni technique, which resulted in an adjusted alpha of .003. Then, the authors used logistic regression analysis to evaluate the linear relationship between vocational rehabilitation services and work status at closure. Then, chi-square tests were used to evaluate the proportions of significant vocational rehabilitation services received by consumers with mild, moderate, or severe/profound cognitive disabilities. Then, the relationship between type of cognitive disability and work status at closure were evaluated for consumers who received vocational rehabilitation services. Those consumers who had not received VR services were then eliminated from the sample. The desktop version of SPSS for Windows, version 11.5 was used in this analysis.
The intervention was vocational rehabilitation services.
There was no control or comparison condition.
The majority of the individuals in the population were Caucasian (73%). Assessment, adjustment, counseling, job-finding services, and job-placement services were received by 81%, 34%, 78%, 60% and 58%, respectively. Analysis of the data found that 8%5 of the participants were closed into competitive jobs following vocational rehabilitation intervention. Consumers with mild mental retardation were significantly more likely to achieve competitive jobs when compared to those with moderate or severe/profound cognitive disabilities. In addition, individuals with moderate cognitive disabilities were significantly more likely to be placed into competitive jobs compared to those with severe/profound disabilities. The odds of obtaining competitive employment for consumers who received job placement services was 2.05 times the odds for those not receiving those services. The odds of obtaining competitive employment for consumers who received counseling were 1.52 times the odds of those who did not receive counseling. The odds of obtaining competitive employment for consumers who received business and vocational training were 2.14 times the odds of those who did not. However, consumers with mild mental retardation were provided with business and vocational training at a significantly higher proportion when compared to those with moderate and severe/profound disabilities. Consumers with moderate mental retardation were no more likely to receive counseling services than those with mild cognitive disabilities. However, consumers with severe/profound cognitive disabilities were less likely to receive counseling services than those with mild/moderate disabilities. Consumers who received job placement services with mild cognitive disabilities achieved competitive jobs at a significantly higher proportion than those with moderate or severe/profound mental retardation. In addition, consumers with moderate cognitive disabilities were significantly more likely to achieve competitive jobs than individuals with severe/profound disabilities. Consumers with mild cognitive disabilities who received business and vocational services achieved competitive jobs at a significantly higher proportion than those with moderate and severe/profound cognitive disabilities. Consumers with mild disabilities who received counseling achieved competitive jobs at a significantly higher proportion when compared to those with moderate and severe/profound disabilities. In addition, consumers with moderate cognitive disabilities were more likely to achieve competitive employment when compared to consumers with severe/profound disabilities.
Consumers with Moderate or severe/profound cognitive disabilities were closed into competitive employment at a significantly lower rate than those with mild cognitive disabilities. Consumers who were provided with business and vocational training, counseling, and job-placement services were significantly more likely to achieve competitive jobs. A significantly lower proportion of these services were provided to consumers with severe/profound cognitive disabilities.
The authors concluded that the significantly higher proportion of consumers with mild cognitive disabilities achieving competitive employment could be related to the specific services they more often receive. Perhaps consumers with mild disabilities are more likely to be provided job-placement services as opposed to those with severe/profound cognitive disabilities. The authors ask the questions: Why do consumers with mild or moderate cognitive disabilities more likely to receive job placement and counseling services compared to those with severe/profound disabilities? They propose that too much attention may be given to assessment/testing results and other nonrelevant dimensions that could prohibit the provision of effective services. They also propose that there may be a subjective belief that places a lesser value on the overall potential of individuals with significant cognitive disabilities. Counselors may believe that consumers with severe/profound cognitive disabilities are more difficult to place. Their expectation of successful employment outcomes may result in less significant placement efforts for this population.
The authors state that their findings raise questions that could not be answered through the RSA-911 database. The database does not provide information on reasons for the provision of certain services to consumers with mild, moderate, or severe/profound cognitive disabilities. The database does not contain information on Counselors' perceptions of service effectiveness or how they provide the specific services. Finally, the small proportion of individuals with severe/profound cognitive disabilities raises an important question about the decision-making process counselors use to determine if a consumer can benefit from vocational rehabilitation services.
